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Onada expansiva aims to be a catalyst for internationalist discussion on current issues with our own research and contributions from any other source.
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Friday, January 16, 2015

NHS and the hydra of cancer drugs prices

We share the January 13th 2015 editorial from The Independent regarding the high cost of some cancer drugs and criticizing,rightfully,the steps taken by the UK government not to heed to NICE advice analysis before adding new drugs to the publicly funded list. A rise in pharmaceutical costs which has more to do with pharma companies pricing and business strategies than actual therapeutic impact and is affecting most European countries. En la web de la No Gracias podeis encontrar tanto el editorial como otros materiales relacionados debidamente traducidos y analizados. As usual we have added some hyperlinks and provided further information on the issue from the blog, our twitter feedand elsewhere

Unhappy pills Manufacturers of cancer drugs cannot expect to keep charging more for them without paying a price themselves With a limited budget, the NHS cannot meet every demand – and new demands keep arising. As accident and emergency departments face unprecedented pressures, despite the relatively mild winter and an emergency cash injection from the Government, they suck resources from other parts of the service which, sooner or later, feel the squeeze. This week it is the turn of the cancer services.

Cancer is an
emotive issue. The diagnosis always comes as a shock. So when the National
Institute for Health and Care Excellence (Nice)
rules that a new cancer drug may not be provided on the NHS because it is too
expensive, it invariably causes heartache and makes headlines.

In August, the
pharmaceutical company Roche became embroiled in a bitter public row with Nice
over the £90,000 price tag for its breast cancer drug, Kadcyla, claimed to extend the
lives of terminally ill patients by six months but which was deemed too costly.
This is not good for patients and it is not good for the NHS.That is why the
Cancer
Drugs Fund was set up in 2010 – to provide stopgap funding for new
drugs and those rejected by Nice (where they were prescribed by a cancer
specialist for an individual patient) to take the political heat out of the
issue. In bypassing Nice it bypassed the principles of fairness and value for
money on which Nice was founded, and has been roundly criticised for doing so.For a while,
however, it worked. It defused what would otherwise have been an increasingly
desperate situation in which some patients were told they could not have the
drugs their cancer specialist had recommended. But now
the Cancer Drugs Fund itself has run out of money, after its annual budget was
increased from £200m to £280m. Yesterday it announced which of the most
expensive drugs it would cease to pay for. The pharmaceutical companies, which
were informed of the decisions affecting their own drugs last week, reacted
with predictable fury.They are,
however, the authors of their own demise, at least in part. Cancer drug prices
have been rising at four times the rate of inflation. The cost of new cancer
drugs more than doubled between 2000 and 2010, to $5,000 (£3,300) a month,
according to a US study. Globally, spending on cancer drugs has risen by 160
per cent since 2003, almost double the rise in the total drug market, to $91bn.
The respected US Institute of Medicine
concluded earlier this year that, in addition to the high cost of developing
new agents, the sharp rise in costs was due to pricing practices, reduced
competition, shortage of generics, and reimbursement incentives.The urgent
imperative for the NHS over the next five years and beyond is to ensure that
maximum value is extracted from every pound spent. One example is the deal
struck with pharmaceutical manufacturers under which they will refund the cost
of drug treatment where it fails to have the expected impact. The makers of two
drugs – bortezomib for the blood cancer myeloma (£9,000 to £25,000 per patient)
and cetuximab for bowel cancer (up to £19,000) – have agreed to refunds for
patients who do not respond.More
manufacturers must follow their example. The scale of the challenge is
daunting. Latest figures show that there were 331,000 new cases of cancer
diagnosed in 2011 in the UK, up by 23 per cent among men and 43 per cent among
women since the mid-1970s. The bill for treating them was put at £5.6bn by an
Oxford University study published in 2012, and it is projected to rise by more
than half over the next decade.As demand grows
on health budgets and the toll from cancer rises, it is vital that we ensure
the money available is spent to the best effect.